Evaluation of the voice function after the supraglottis subtotal laryngectomy

Voice quality was analysed in 39 patients with the larynx carcinoma after the supraglottis subtotal laryngectomy. Voice pattern was analysed with the use of subjective and objective spectrography before and after the surgery. A deteriorated voice quality was found after the surgery. The spectrographic examination revealed decreased frequency levels of the formants F3 and F4 and the presence of a noise component generated in the glottis area.     

Investigating the effects of subthalamic Nucleus–Deep brain stimulation on the voice quality

Abstract

Introduction: Deep brain stimulation (DBS) is a standard surgical treatment method which is generally applied to subthalamic nucleus in Parkinson’s patients in cases where medical treatment is insufficient in treating the motor symptoms. It is known that Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) treats many motor symptoms. However, the results of studies on speech and voice vary. The aim of the study is analysing the effect of STN-DBS on the characteristics of voice.

Materials/methods: A total of 12 patients, (8 male–4 female) with an age average of 58.8?±?9.6, who have been applied DBS surgery on STN included in the study. The voice recordings of the patients have been done prior to surgery and 6?months after the surgery. The evaluation of voice has been carried out through the instrumental method. The patients’ voice recordings of the /a,e,i/ vowels have been done. The obtained recordings were evaluated by the Praat programme and the effects on jhitter, shimmer, fundamental frequency (F0) and noise harmonic rate (NHR) were analysed.

Results: Numerical values of F0 of all female participants have been decreased for all of the vowels postoperatively. In the females; jhitter and fraction parameters were found to be significantly different (0.056 and 0.017, perspectively) for the vowel /e/. In addition, p values in the shimmer for vowels /e,i/ were thought to be clinically significant (.087, .079 and .076) respectively. All these changes in second measurements were found to indicate worsening vocal quality after the DBS in females. In males, there is not any significant difference observed between two measures in any of the parameters of any vowels.

Conclusions: Acoustic voice quality deteriorated after STN-DBS predominantly for females however this deterioration was not prominent audio-perceptually. This finding commented as a result of the fact that that voice quality deviance of the participants was not severe.     

康复治疗在声带小结术后改善嗓音音质中的应用

目的:观察康复治疗在声带小结术后改善嗓音音质中的作用。方法:118例声带小结术后患者随机分为康复治疗组59例,对照组59例。对照组只进行手术治疗。康复治疗组利用理学疗法中的高频超短波、激光两种物理因子作用于声带体表投影处;运动疗法采用被动的颈部按摩以及主动的呼吸练习、打哈欠—叹气练习、水泡音练习、咀嚼练习、放松练习进行针对性训练12周。结果:康复治疗组患者治愈率更高,术后嗓音音色质量更好(P0.05)。结论:康复训练能提高声带小结手术治疗的效果,促进嗓音音质改善。     

康复治疗在声带小结术后改善嗓音音质中的应用

目的：观察康复治疗在声带小结术后改善嗓音音质中的作用。方法：118例声带小结术后患者随机分为康复治疗组59例,对照组59例。对照组只进行手术治疗。康复治疗组利用理学疗法中的高频超短波、激光两种物理因子作用于声带体表投影处;运动疗法采用被动的颈部按摩以及主动的呼吸练习、打哈欠一叹气练习、水泡音练习、咀嚼练习、放松练习进行针对性训练12周。结果：康复治疗组患者治愈率更高,术后嗓音音色质量更好（P〈0．05）。结论：康复训练能提高声带小结手术治疗的效果,促进嗓音音质改善。     

Voice analysis after the partial laryngectomy in patients with the larynx carcinoma

The paper presents 170 cases of patients with the larynx carcinoma after the partial laryngectomy. According to the procedure which we used, vertical, horizontal and subtotal supraglottis laryngectomies were distinguished. Voice pattern was analysed with the use of subjective and objective spectrography. The lowest degree of dysphonia was found in patients after the horizontal laryngectomy, while the highest degree dysphonia in those after subtotal supraglottis laryngectomy.     

Voice quality in Parkinson's disease in the Croatian language speakers

Parkinson's disease (PD) is well known to cause voice impairments. The aim of this study is to evaluate subjective and objective changes in voice quality in patients with PD in Croatian language speakers. Twenty one patients (11 male and 10 female) with PD and twenty one age-matched (10 male and 11 female) of the control group were assessed. Voice impairment was scored according to Voice Handicap Index (VHI). Patient's perceptual voice analysis was assessed using GRBAS scale including Grade of Dysphonia, Roughness, Breathiness, Asthenia and Strain items. The analysed objective voice parametars were: fundamental frequency, highest frequency, lowest frequency, voice range, jitter, shimmer, maximum phonation time and s/z ratio. In all patients we performed videolaryngostroboscopic examination. Compared with the control group we found the significant differences in VHI, in GRBAS scale (p < 0.05 in all items except asthenia). On videostroboscopic examination, laryngeal tremor was present only in PD group (6 patients), abnormalities of the mucosal wave was found more frequent in PD group (17 versus 8 patients) and also non-closure glottis pattern (11 versus 6 patients). There was no significant difference in the objective voice parametars except in maximum phonation time which was shorter in PD group (15.8 seconds and 23 seconds, p = 0.014) and voice range, which was shorter in PD group (111 Hz versus 147 Hz, p = 0.0465). No one of patients with PD was included in any form of speech therapy. The voice disability in PD is generally well known, but very often underestimated. In this study we found which components of voice were more affected. The voice quality has a significant impact on life quality and potential in assessment for severity of disease state and for the efficacy of treatment.     

Long-term outcome after respiratory rehabilitation.

To determine the long-term effect of respiratory rehabilitation, we followed up for 6 months after discharge 31 consecutive patients enrolled in a multidisciplinary inpatient rehabilitation program lasting 4 to 6 weeks. Of the 31, 24 showed improvement in quality of life (as measured with a previously validated questionnaire) and in functional exercise capacity (as measured with the 6-minute walk test) 2 weeks after discharge. The improvement was sustained for 6 months in 11 of the 24. Other investigators have found higher response rates than those that we report. The differences are likely due to our enrolment of consecutive patients, the length and completeness of follow-up, and the objective measurement of quality of life by an interviewer not associated with the rehabilitation program. Controlled trials of respiratory rehabilitation measuring both costs and benefits are warranted. In the meantime, strategies to maintain the initial improvement seen after rehabilitation should be developed and studied.     

Rehabilitation of Paralytic Dysphonia

Vocal rehabilitation has been successful for patients with paralytic dysphonia. At the discretion of the laryngologist, vocal rehabilitation is used alone or in combination with intracordal injection. Except for post-surgical patients, a complete diagnostic evaluation is advisable before vocal therapy is undertaken. During vocal rehabilitation, pitch, volume, quality, breath support and the vocal image are realigned to afford an optimal and efficient voice.For the 18 patients completing vocal therapy, the results were excellent in 14 and good in four. Vocal therapy was completed within six months for 11 patients; seven were treated for periods ranging from six months to a year.     

持续静态牵伸技术在肘关节康复训练患者中的临床疗效观察

为了探讨肘关节骨折患者行骨折术后采用持续静态牵伸技术结合常规功能康复的应用效果,并揭示其对患者生活质量的影响,本研究选取我院手术治疗的84例肘关节骨折患者,收集时间为2015年1月至2016年12月,其中42例患者术后接受常规功能康复(常规组)、另外42例患者在常规功能康复基础上加用持续静态牵伸技术(研究组),观察两组患者术后3个月和6个月时的肘关节功能和生活质量的差异。研究显示,术后3个月和6个月,研究组的疼痛、功能、矢状面活动、肌肉力量、屈曲挛缩、旋前、旋后评分均显著高于常规组(p<0.05);术后6个月,研究组的FIynn肘关节功能评价(优78.57%,良16.67%,可4.76%)优于常规组(优57.14%,良30.95%,可11.90%),差异具有统计学意义(p<0.05);两组患者术前生活质量无差别。术后3个月,研究组患者躯体功能、肢体疼痛等生活质量得分高于常规组。本研究表明,肘关节骨折患者行骨折术后采用持续静态牵伸技术结合常规功能康复可显著改善患者术后的肘关节功能,值得临床推广应用。     

Quantitative voice quality analyses of a soprano singing early music in three different performance styles

This paper considers the measurement of voice quality variations relating to three different performance styles of early music singing by a trained soprano. In particular, the various outputs available following the collection of electrolaryngographic data are presented along with acoustic analyses based on the acoustic pressure waveform to enable a comparison of the three different singing styles. Voice quality analysis is based on the output from the electrolaryngograph, that enables a measurement of fundamental period to 1 μs accuracy to be made, enabling fundamental frequency variations including vibrato to be explored. In addition, the percentage of each cycle for which the vocal folds are in contact is measured and varies between the three voice qualities providing insights into the nature of vocal fold vibration in each case. Acoustic output spectral measures are made that are not only based on traditional wide- and narrow-band but also hearing modelling spectrography. These provide a clear indication as to which portions of the spectrum are most prominent in terms of perception of the three different voice qualities. A number of features resulting from the various analyses distinguish the singing styles, thereby providing evidence that the methods used are appropriate for objective characterisation and differentiation of singing styles in early music.     

关节镜手术在膝关节骨性关节炎患者中的综合应用价值

目的:研究关节镜手术在膝关节骨性关节炎患者中的综合应用,为膝关节骨性关节炎的临床治疗提供依据。方法:选取50例单膝关节骨性关节炎患者,行常规关节镜手术,术后注射透明质酸钠并指导患者进行康复训练。在关节镜手术前后对患者进行LKSS评分,评定患者膝关节功能;对患膝的屈肌、伸肌力进行等速测定;在术前及术后2周测定外周血及患膝关节液IL-6、TNF-α、MMP-3表达水平。结果:与术前相比,患者术后LKSS评分及关节活动度均显著提高(P0.05),关节功能得到较好的恢复;患膝伸肌PT、STW及TAE值均得到显著提高(P0.05),屈肌PT、STW及TAE值无统计学意义;患者外周血及关节液中IL-6、TNF-α及MMP-3表达水平均显著降低(P0.05)。结论:采用关节镜手术治疗骨性关节炎可明显降低机体的炎症状态,改善关节的功能,增加患膝的伸肌力。     

The therapeutic effect of aerobic exercise with resistance training in elderly men with type 2 diabetes mellitus

Objective: This study was conducted to examine the effects of aerobic exercise alone and aerobic exercise with resistance training on the quality of life in men over the age of 55 years with type 2 diabetes mellitus. Methods: A total of 54 participants were divided into the following three groups so that there were no significant differences in blood chemistry or physical ability indexes among the three groups: control, aerobic exercise, and aerobic exercise with resistance training. The latter two groups exercised for 24 weeks, while the control group performed no exercise. Blood chemistry levels and measures of physical ability in each group members were examined one day before and one day after the exercise regimens. Results: Compared with those before the study, blood glucose, glycated hemoglobin, triglycerides, cholesterol, and low-density lipoprotein levels as well as vital capacity, reaction time, sit-and-reach ability, and balancing while standing on one leg with closed eyes were significantly improved in the aerobic exercise only group(P 0.05). All these measures as well as high-density lipoprotein levels and grip, back, and leg strength were significantly improved in the combined aerobic and resistance training group(P 0.05). By contrast, no significant differences before and after the experiment were found in any measure for the control group(P 0.05). Conclusion: Although both aerobic exercise and aerobic exercise combined with resistance training for 24 weeks effectively improved the quality of life in patients with type 2 diabetes, the effect of the combined training was better than that of aerobic exercise alone. These results suggest that resistance training may be safely added to the rehabilitation training regimen of patients with type 2 diabetes mellitus.     

Activation of Markers of Inflammation,Coagulation and Fibrinolysis in Musculoskeletal Trauma

Background

Traumatic injury induces changes in mediators of inflammation and coagulation, but the pivotal roles of inflammation and coagulation has not been precisely clarified. Therefore we have studied markers of inflammation and coagulation after a standardized musculoskeletal trauma like total hip replacement surgery.

Methods

We allocated 21 patients aged 50 to 84 years who underwent total hip replacement surgery. Releases of TNF-α, IL-1β, IL-6, IL-8 and IL-10 and protrombin fragment F1.2 and plasmin-antiplasmin complex (PAP) were examined during surgery and up 6 days postoperatively, and systemic releases were compared to pre-operative values. Surgery induced significant increments in serum levels of IL-6 at 6 hours and at 1 day after surgery and in levels of IL-8 at 6 hours after surgery. There were no significant changes in serum levels of TNF-α, IL-1β or IL-10. There were significant increments in blood levels of F1.2 and PAP up to 6 days postoperatively with highest levels at 6 hours after surgery. There were only week correlations between IL-6 and IL-8 and F1.2 and PAP.

Conclusion

Major musculoskeletal surgery causes changes of the inflammatory, coagulatory and fibrinolytic cascades in stable patients, but with no correlations between inflammation and coagulation and fibrinolysis.     

Serum changes in trace elements during thyroid cancers

The objective was to examine changes in trace elements due to thyroid cancer in humans. Serum levels and tissue contents of trace elements (Zn, Cu, Mn, Mg, Fe and Se) were measured in 43 patients with thyroid cancer before and 4 days after surgery were compared to normal values. The serum levels of zinc in cancer patients were lower than those of normal subjects. Surgical removal of the cancer resulted in the restoration of these levels. Although serum Cu levels in patients were not different from normal, but post-operatively these levels rose significantly (p < 0.001). Levels of Fe, Mg and Mn were significantly lower (p < 0.001) post-operatively. There was no significant change in Serum Se levels. The thyroid tissue contents of these trace elements did not show a difference between the normal (Juxta-tumor) thyroid tissue and the cancerous lesion. Out of the six trace elements examined, the decrease of serum levels of zinc in cancer patients may be linked to the disease condition. It is suggested that this change: (a) may be used to demonstrate successful cancer surgery and (b) may have implications for a long-term follow-up of thyroid cancer patients.     

Serum changes in trace elements during thyroid cancers

The objective was to examine changes in trace elements due to thyroid cancer in humans. Serum levels and tissue contents of trace elements (Zn, Cu, Mn, Mg, Fe and Se) were measured in 43 patients with thyroid cancer before and 4 days after surgery were compared to normal values. The serum levels of zinc in cancer patients were lower than those of normal subjects. Surgical removal of the cancer resulted in the restoration of these levels. Although serum Cu levels in patients were not different from normal, but post-operatively these levels rose significantly (p < 0.001). Levels of Fe, Mg and Mn were significantly lower (p < 0.001) post-operatively. There was no significant change in Serum Se levels. The thyroid tissue contents of these trace elements did not show a difference between the normal (Juxta-tumor) thyroid tissue and the cancerous lesion. Out of the six trace elements examined, the decrease of serum levels of zinc in cancer patients may be linked to the disease condition. It is suggested that this change: (a) may be used to demonstrate successful cancer surgery and (b) may have implications for a long-term follow-up of thyroid cancer patients.     

活血止痛熏洗剂联合功能康复训练对踝关节骨折术后功能恢复及生活质量的影响

目的:探讨活血止痛熏洗剂联合功能康复训练对踝关节骨折术后功能恢复及生活质量的影响。方法:将150例踝关节骨折患者,按照随机数字表格法分为观察组与对照组,各75例。观察组患者于手术后2周给予活血止痛熏洗剂联合功能康复训练,对照组手术后单纯给予功能康复。比较两组患者治疗前后功能恢复情况及生活质量变化。结果:观察组的有效率为88.0%,高于对照组的69.3%,两组比较差异显著具有统计学意义(X~2=7.786,P0.05)。治疗后,观察组的症候功能积分低于对照组,观察组的AIMS2-SF生活质量积分高于对照组,两组比较差异著性(P0.05)。结论:活血止痛熏洗剂联合功能康复训练治疗踝关节骨折术后的临床疗效确切,患者症状明显改善,患者生活质量显著提高,临床上应该推广应用。     

Assessment of the efficacy and safety of low frequency,low intensity magnetic fields in patients after knee endoprosthesis plasty. Part 2: A Clinical Study

The purpose of this clinical study was to assess low frequency, low intensity magnetic fields in the enhancement of the physical rehabilitation of patients after knee endoprosthesis surgery. The study included 62 patients who underwent total knee arthroplasty. Group A consisted of 32 patients who were physically rehabilitated. Group B consisted of 30 patients who were physically rehabilitated and treated additionally with pulsing magnetic fields (5 mT, 30 Hz, 20 min once a day, 5 days weekly). Therapy lasted 3 weeks for both groups. The rehabilitation process was evaluated using a goniometer, tensometer, goniometric pendulum test, Lysholm scale for knee function, and a visual analogue scale (VAS) questionnaire for pain and activity. The changes of measured rates were comparable in both groups. Low frequency and low intensity magnetic fields of examined parameters were not demonstrated to effectively improve the rehabilitation of patients after knee endoprosthesis surgery. Bioelectromagnetics 30:152–158, 2009. © 2008 Wiley‐Liss, Inc.     

Effets de la chirurgie á coeur ouvert sur les mécanismes de défense contre lea infections bactériennes

Extracorporeal circulation during open-heart surgery may damage cellular and humoral factors in the blood. Phagocytic functions of circulating polymorphonuclear leukocytes were investigated in 10 patients 1 day before, then 1 hour, 2, 4 and 10 days after open-heart surgery. Transient diminutions in the phagocytic capacity of polymorphs was found for Staphylococcus aureus and Escherichia coli in one patient, and E. coli only in two patients up to the 4th postsurgical day. A positive correlation was found between the duration of extracorporeal circulation and the transient diminutions in phagocytic capacity for these three patients. However, the bactericidal capacity of polymorphs and their capacity to reduce nitroblue tetrazolium were normal in all patients. The serum concentrations of total hemolytic complement, C3, IgG and IgM were generally diminished up to the 4th day after surgery, but the opsonic power of the serum was almost normal in all the patients.     

Analysis, identification and determination of urinary modified nucleosides of cancer and AIDS patients

Modified nucleoside levels in urine samples collected before and after surgery from seven patients with malignant gastrointestinal cancer were examined by the reversed-phase HPLC method. Those of an AIDS patient, a breast cancer patient, and pooled normal urines were also compared. To monitor the effects of therapy on cancer patients, the levels of modified nucleosides, especially t6A and MTA, were found to be fairly effective. In an AIDS patient, the levels of most of the nucleosides exhibited remarkable increases compared to normal urine.     

Effects of a comprehensive cardiac rehabilitation program on quality of life and exercise tolerance in women: A retrospective analysis

BACKGROUND: Currently, there are a lack of investigations that have examined the effect of participating in a comprehensive cardiac rehabilitation program on quality of life and physiological measures in women of different ages. The purpose of this investigation was to examine the effect of participating in a comprehensive cardiac rehabilitation program on quality of life, exercise tolerance, blood pressure and lipids in women between 33 and 82 years of age. METHODS: The 126 women participated in a 14-week cardiac rehabilitation program that consisted of 7 weeks of formal supervised exercise training and 7 weeks of unsupervised exercise and lifestyle modification. Physiologic and quality of life outcome measures obtained at the outset and after 14 weeks included: 1) exercise treadmill time; 2) resting and peak systolic and diastolic blood pressure; 3) total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol and Triglycerides; 4) Cardiac Quality of Life Index questionnaire. RESULTS: Significant improvements were found in the following quality of life measures after participating in the cardiac rehabilitation program: physical well being, psychosocial, worry, nutrition and symptoms. No significant differences were seen for any QOL variable between the different age groups. Significant improvements were seen in exercise tolerance (+21%) and high density lipoprotein (+5%). CONCLUSION: Cardiac rehabilitation may play an important role in improving quality of life, exercise tolerance and high density lipoprotein cholesterol levels in younger and older women with underlying cardiovascular disease.